The NY State Commission on Health Care Facilities in the 21st Century released its final report yesterday.  Its recommendations include the closure of nine hospitals, merger or other restructuring of about fifty hospitals and the elimination of 4,200 hospital beds (7% of the state’s total supply), and the closure of 2,000 nursing facility beds (4% of the state total).

Many of the institutions welcome these recommendations and have been involved with their development. 

The press release accompanying the report notes:

The Commission’s recommendations will produce an estimated total benefit to payors and providers of over $1.5 billion annually, or $15 billion over ten years. Included in this figure is an estimated $806 million annually in savings to Medicaid and other payors. Thebenefits to providers in the form of reinvestment opportunities are estimated to be $721 million annually.

. . . .

The Commission’s report also includes recommendations for broad policy reform in the areas of reimbursement, the uninsured, primary care infrastructure, workforce development, the SUNY hospitals, county-owned nursing homes, and information technology. Such recommendations provide a blueprint for further efforts to fully reconfigure the health care system.

As the former CON lawyer for the Commonwealth of Massachusetts, I still have the central health planning gene somewhere in my makeup.  Even though I realize that the need to close and consolidate facilities is a result of market pressures from payors and specialized competitors, part of me reacts to this report by thinking: What a colossal waste of resources!  This could have been managed so much better with a little central health planning.  Those were the days . . . .

The approach to nursing facility bed reduction is philosophically similar to policies in play here in Massachusetts — the idea is that many nursing facility residents could be cared for in community-based settings.  While this may be true for some residents, the advocate community is rightly concerned that perhaps too many residents may be displaced or may be left in the future without appropriate placements.

As other states consider undertaking studies such as the one New York has just completed (New Jersey comes to mind; I’m sure there are others), it will be very interesting to see how the implementation of the recommendations in this report unfold. 

— David Harlow